Blogs

Paging Dr. Snake: Researchers Create Therapeutic Venom Database

Could venom from dangerous animals be used for medicine? Data scientists say it already has, and finding studies should be easier.

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Are Your Patients Damaging their Teeth with Whitening Products?

Are Your Patients Damaging their Teeth with Whitening Products?

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Is My Patient a Hyporesponder?

The importance of learning and disclosing all medications of a current patient is important, and may be a clue to why a patient doesn't respond to sedation as expected.

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Is Your Prescription Bankrupting your Patients?

What's behind the extreme variability in drug prices these days? Incisor takes a look at how fluctuations affect clinicians and patients alike.
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The Rise of No-Drill Dentistry

Is dentistry moving away from the handpiece? New atraumatic techniques may preserve oral health without the need for fillings in early cases.
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Tooth Extraction After Heart Surgery

A patient needs an abscessed tooth extracted, but his blood-thinning medication could complicate the procedure. DOCS Education faculty weigh in.
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Mind Your Manners with Sedated Patients

How much can sedated patients really remember? More than you think, says new study.
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A Clinical Imperative: Educate Your Patients About Antibiotics

Are you ready to join the fight against antibiotic resistance? An easy way to do your part as a community medical professional.
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ADA Resolution 77 Update: It's Not Over Yet!

You may know the final outcome of the ADA House of Delegates vote on Resolution 77. But understanding the who, how and what's next is just as crucial.

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Discharge Protocols after Sedation Appointments

Is there cause for concern if a patient's sedation level seems to increase after leaving the office, even if they are "perked up" by the administration of sugar post-operatively?

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A member of DOCS Education needs clarification on what constitutes a sedation protocol, as well as the proper procedure for their patient.
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A member of DOCS Education asks:

I am showing some [D] interactions on Lexicomp for triazolam, diazepam, hydroxyzine and Ambien® as well as Norco®. We could skip the Ambien®, but I still have concerns about the Norco®. Any suggestions? This is a chronic pain patient.

Thanks


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A member of DOCS Education asks:

It seems I have an abundance of cops and nurses in the practice, and all seem to be taking some form of anti-anxiety meds or BP meds. Well, someone has to treat them and I have had great success with the DOCS protocol, but could use some suggestions here on an upcoming patient:

Patient is 5 9" / 220 lbs. He is a half-pack a day smoker. No snoring, or so he says. BP today was 148/89, HR 86'. I have seen diastolic pressure at 95 on a previous visit. Meds are as follows:


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A member of DOCS Education asks: My patient is a 21 year old female who presents for IV sedation and operative dentistry. She smokes 0.5 packs/day, reports she has bronchitis but has no medication for such. She also states she takes Depakote® for bipolar disorder and Propranolol for tachycardia. Lexicomp shows no interactions with the Depakote® and only a C rating for Fentanyl (a non-benzodiazepine) and Propranolol. No other interactions are listed.
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A Member of DOCS Education asks: The Sedation Dentistry Guidebook offers a form titled "Sedation Appointment Checklist." The checklist outlines some instructions specifically for smokers, specifically how long to refrain from smoking after a sedation appointment. To clarify, are we to use this form to communicate to patients how long they are not to smoke before their sedation appointment? I remember from the DOCS course that smokers were encouraged to smoke before and throughout the sedation appointment as needed. Do we offer this option to all patients that smoke, or only to those who smoke beyond a specific threshold of cigarettes per day? Off of that, what is the protocol for allowing a patient to smoke during the sedation appointment? Should we keep the pulse ox attatched to the patient and accompany them outside? Any clarification would be appreciated?
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A DOCS Education member brings this question to the forum: I would appreciate some input regarding this patient, a 56 year old female, 5 feet and 1.5 inches tall, 248 lbs. She is a non-smoker. I have an upcoming treatment appointment with her and I plan on using a Triazolam titration protocol with her starting with .25 mg of Triazolam one hour prior to her appointment. She reports the following medical conditions: Hypertension Diabetes Asthma Hay Fever Hypothyroidism Fibromyalgia
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